Health Status and Health Care

Indicators of Health

In 1996 the United Nations Development Programme (UNDP), which worked
together with the Applied Economic Research Institute (Instituto de
Pesquisa Econômica Aplicada--IPEA), released its Human Development
Report 1995 for Brazil. Using an index based on income, education,
infant mortality, and other socioeconomic indicators, the report showed
that Brazil was in a medium human development position as compared with
other countries. It suggested that the national territory could be
divided into three parts, with standards of living similar to those
found in Belgium (the South and Southeast), Bulgaria (Center-West and
North), and India (Northeast).

As in the Human Development Report 1995 , infant mortality
rates (deaths of children less than one year of age per 1,000 live
births) often are used as indicators of living conditions. Since the
denominator is births, they are not affected by the population's age
structure. Because of underreporting of vital statistics, they must be
estimated from census data. The overall average infant mortality rate
for Brazil declined from 117 per 1,000 live births to eighty-eight,
according to the 1960 and 1980 censuses, respectively. The 1991 census
showed that the rate dropped to 49.7 in 1991. In 1995 the estimated rate
was 44.4 per 1,000 live births.

As usual, national averages mask wide regional and socioeconomic
variations. As in previous decades, infant mortality levels in 1995 were
lowest in the South, at 21.1, and highest in the Northeast, where they
reached 70.2, more than three times higher. In recent decades, infant
mortality generally has been higher in rural areas, except for the
poorest urban strata, whose mortality has been higher. State infant
mortality rates fluctuate from year to year, depending on economic and
public health conditions.

The sharp drop in infant mortality in recent decades did not
necessarily reflect a commensurate general improvement in living
conditions. To a large extent, the drop was the result of both the
decline in fertility, which decreases the risk of infant deaths for
biological and socioeconomic reasons, and specific health and sanitation
interventions, primarily use of oral rehydration and extension of piped
water.